CLINICAL OBSERVATIONS ON VARIOUS DISEASES,

829 studied the deformities in connexion with ation is an injury to a piece of art; and, : the beauties of the human face. accordingly, when the ancients repreNow, with respect to the mouth. The sented centaurs, they were careful to give mouth is not the mere organ of mastica- ’. to each figure, not the perfect form of tion, or the mere organ of speech. If it’ the head, but something that indicated the be considered too much in the latter light, lower animal, varying the action of the its character will be diminished as regards’lips, or the shape of the mouth. Some- B its property of mastication; and if that be the jaw was depressed, and there was diminished, and the expression of speech aa. large nostril; sometimes the eyes were only be retained, then the mouth will be! small, and the ears were tipped with the small, and the lips and cheeks full, and ; character of those of the dog or some you will have precisely the character of’ ; inferior animal. On the other hand, when the lower part of the antique head. If, onthey represented Jupiter, the reverse was case. Everything pertaining to the the contrary, you enlarge the jaws, give squareness to the chin, prominence to the lower animal was avoided, and all that angle of the jaw, and an undue proportion belongs to the perfect human character to the whole, as an instrument of mastica- was exaggerated. There was not only that tion, you will then give a vulgar, if not a pushing forward of the upper part of the face which characterizes the antique head, brutal, character to the countenance. Exactly the same principle applies to but there was given to the statue the chathe eye; but then the eye is a proper or- racter of fulness and beauty in the chin, of the mouth which porgan of inferior animals, and is not con- that nected with anything injurious to the su- tends its capacity of speech rather than of periority of the human character. Accord- mastication;an eyebrow fine and eningly, you find that the poets gave beauty larged, the eye expansive, the orbit proeven to the eye of the ox; and if you inves. digiously enlarged, the forehead itself very and smooth, and the ears, as the tigate your own feelings, you will find tha1 the perfection of the eye has nothing to d( last instance, more similar to the human with the brutalizing character of the whole than all the other characters. If you add to what the ancients studied to effect, the head. modern doctrine of association, you will regard to the nose, one of our physiologists, notwithstanding his great find, in the principle of association, which genius, has conceived that the nose is secretly influences every one of us, the reaespecially the part which gives a character son why we acknowledge the beauty of of brutality, because in that instrument; the antique head, at the very time that we the power of smelling, and no other, isare obliged to admit that there is not a provided for, that being a mere animal particle of it which is natural. gratification. Others conceive that the nose is a part which, being large, and liable to much variation in size, tends to diminish the dignity of the human counte- CLINICAL OBSERVATIONS nance. But these individuals forget that ON the nose is not employed so much for smellingas for speech. It is the organ, VARIOUS DISEASES, in fact, which chiefly distinguishes the face BY of man from that of the brute. A certain analogy, a due proportion, of the human MR. WARDROP. face, is necessary for the perfection of the human character ; and if you look to the A MODE Of REMOVING TUMOURS works of art, you will find that the artists, ON GROWING WITHIN THE MOUTH, ATaware of this, made depressions in the TACHED TO THE BONES. bridge of the nose, and gave unusual expansion to the nostril, when sculpturing THERE are several distinct species of tutheir satyrs. But whenever they wanted mours, or polypi, which grow within the to mark distinctly the human character in mouth, but the following observations apperfection, and were intent on giving dig- ply only to those excrescences which either nity to the human countenance, the re- originate in, or are intimately connected verse of all this prevailed in their figures. with, the bones. Wecome next to the ear, and find that The tumours to which I allude are most the same obtains in that part. Wherever commonly met with on the upper or the ear is large, wherever it is pointed, lower jaw, at the base of the alveolar prowherever it assumes the character of an cesses. They appear to be composed, ex. inferior animal, the effect is injurious to ternally, of several rounded masses, of a the human countenance. (I am speaking dark purple colour, possessing a more or

times

.

the

character

capacious

With

of

a

sculptor’s productions.)

first

Such a form.

less soft, elastic, feel;

and

adhering,

im-

830

moveably, by a broad base, to the subjacent

the case of the present youth, and with the most perfect success. After dissecting away the tumour, the kali was rubbed over the raw surface of its base. The adjacent sound parts being carefully protected with dossils of lint, the kali was repeatedly applied to the surface, which was again and again cleared by rubbing off the dead portions after each application of the kali. This process, cautery. In those cases where I have employed which occupied a considerable time, was these means, failure has generally re- daily repeated. Finally, the bone was sulted ; and I have often witnessed very laid completely bare, and in a few weeks a cruel and severe operations fruitlessly re- bone exfoliated, consisting of a thin lasorted to, when thus attempting to re- mella of considerable breadth. The vacuity which remained, and which move large tumours of this description. The history of the two following cases was large, from three of the teeth having points out not only an effectual, and easily been removed, rapidly granulated and cimanageable, but a much less formidable, catrized, and when I saw this patient a mode of eradicating such tumours. years afterwards, I was astonished to that the contiguous teeth had coafind Case 1.—A youth applied to me on acfilling up the deficiency in the jaw count of a tumour situated on the lower in a most extraordinary manner. jaw, which had displaced, and occupied the situation of, two of the incisores and caCase 2.-A gentleman, forty-five years nine teeth, and extended to the first mo- of age, had a tumour of the upper maxlares of the left side of the lower jaw. It illa, which completely filled up the space had a nobbed surface, was of a dark pur- between the four incisores and lip, and ple colour, and adhered firmly to the al- was so large as to elevate the lip and deveoli by an extended base. form the countenance. It was of a dark purple colour, had a firm fleshy feel, and adhered immoveably by a broad base to the subjacent bone. I dissected back the lip, to expose the whole tumour, and then removed all that portion which the knife could reach, and afterwards freely rubbed the kali parum on the raw surface. The application of the kali was repeated everydayfor some time, and subsequently every other day. Ultimately the alveolar processes were completely exposed, and exfoliating portions of the thin external laminse daily separated, so that in a few weeks the whole I removed this excrescence, and cut it dead bone had exfoliated, and the surface away closely to the bone. Soon after- which it exposed was afterwards speedily wards it grew again; when, besides re- covered with granulations, which cicamoving the fleshy mass, a portion of the trized, and left little deformity. subjacent bone was taken away with a trephine. The tumour grew a third time; Remarks.-These cases will suffice to and dreading its progressive increase, I show the advantages to be derived from contemplated, as the most certain means this mode of treatment, for it is evident of curing this disease, the removal of a that by the knife alone it is impossible to considerable portion of the jaw. destroy such tumours, as they grow in situMr. GEORGE YourrG was consulted on ations where it is often not practicable to this point. He related to me an instance saw off, or otherwise remove, the diseased of a large tumour of the same description portions of the bone from which they growing from the antrum, which, after grow. Nor can the actual cautery answer having been unsuccessfully removed with the intended purpose, unless by such frethe knife, he completely eradicated by quent repetitions of a painful operation as producing an exfoliation of the bone from few would allow. The common lunar caustic is quite whence it grew, by the repeated application of kali purum. This rational prac- useless in such cases; as the length of time tice, and Mr. YouNG’s ingenious mode occupied by the formation and separation managing it, were immediately adopted in of an eschar renders it too inert a remedy,

bone.

Tumours of this description also grow/from the antrum and other cavities nose; and, if allowed to increase, Sometimes attain an enormous bulk, and ultimately destroy life. The modes which have been usually resorted to for removing such tumours are, extirpation with the knife, and the actual

of the

few

lesced,

,

of

831 the tumour being moreI j four hundred individuals suffered from thi destruction effected by the:frightful disease, a large proportion of caustic, whereas the kali purum possesseswhom came under my own observation. all the advantages of the actual cautery inThough different modes of treatment were the rapidity of its action, and of the lunar the most decided benefit resulted of its application. from salt emetics, the more especially when caustic in the The kali destroys the life even of skin, during the earlier stages of most as quickly as the cautery, so thatthe disease,-the most striking advanslough after slough may be produced, and being derived from the use of cain the latter stages; these advana large portion of the diseased growth the more certain whenever being daily destroyed. Besides, it has the tagesexhibition of the calomel had been vantage of being applied with great precision to any particular part, by which only by the use of the salt emetics. the diseased portion is destroyed, and the " 259, Oxford-street, August 31st, 1g34:’ necessary quantity of bone With regard to the pain produced, this mode is decidedly preferable. The appliCASE OF cation of the kali on the tumour produces but slight uneasiness, and I have been surASCITES OF THREE YEARS prised how little a patient complains nn-i DURATION, less it touch the sound and healthy parts.i I think it also extremely probable that CURED WITH THE this practice may be beneficially adopted for the removal of tumours in other parts OF POTASH. of the body, which are attached to bones, W. P. BAIN, M.D., Surgeon, Poplar. or for the removal of diseased bones them-

the

growth of

rapid than the

nicety

I tried,

al-administered tages

thus lomel adi the

I denuded.preceded

HYDRIODATE

selves. Case 3.-A lady had for many years a small abscess on the heel, at the bottom of which Mr. Young could feel, with a probe, a piece of carious bone. In place of resorting to a severe operation with the knife, he enlarged the sinus with the kali, and then applied it to the carious portion of the os calcis, which soon exfoliated, and the patient completely recovered.

!

; ’

By

I WAS requested in January last to visit Mrs. G--, astat. 40, whose case presented the following symptoms :-The abdomen is much distended and fluctuation is very perceptible, with anasarcous swelling of the ankles ; respiration is difficult, ! especially at night, when it is attended with a sense of suffocation; has a slight cough, with adherent sputa, and auscultation gives evidence of the rale sibilant, ENIETICS OF SALT AND WATER IN which, however, is variable in its seat ;y CHOLERA. the pulsation of the heart is very percepWITH a view of still further confirming tible to the eye, even at the distance of the valuable observations of Mr. BEAMAN some paces, and the stroke is heard over a on the use of salt-and-water emetics in large extent, but without any anormal the treatment of cholera, I am persuaded sound. The veins of the neck are swollen, that the following abstract of a communi- and the countenance partakes of a livid cation made to me by Mr. BIRD will be hue. The liver feels enlarged ; skin dry; read with interest :tongue rather clean; bowels inclined to " The calomel was always very largely be constipated; the urine is small in quanadministered, ten grains being the usual tity, and deposits a thick reddish sedidose, which was repeated every hourment. until the symptoms yielded. In one severe Has had nine children, and frequent case of the disease, ten grains were at miscarriages; her liver was affected many first given every quarter of an hour, and years ago, for which she was salivated to repeated afterwards at such intervals, that a great extent, and has in consequence lost the whole quantity taken by this patient almost all her teeth. She has perceived in twenty-four hours amounted to no less an increased pulsation of the heart for than two hundred and forty grains; and many years. it is worthy of remark, that he recovered During her last pregnancy, three years without having any of the usual effects ago, she first perceived a swelling in her which mercury produces on the constitu- ankles, and some time after her confinetion. ment the abdomen became distended. She " In the month of November, 1832, consulted Mr. M. Tatham of this place, cholera raged with very considerable who attended for a period, and adminisviolence at the Dowlais Iron Works, neax tered various remedies with partial success. Alerthyr Tidvil, in Wales. Upwards oj Emetics continued to be given every morn-